Woes At Facilities Worry State

July 10, 2007|By HUGH LESSIG, hlessig @dailypress.com | 804-225-7345

RICHMOND — About one in five assisted living homes in Virginia concern state investigators because of too many verified complaints, problems meeting state standards, or both, according to a report released Monday.

And the near-term outlook for improving that number appears to be mixed, with potential budget pressures on the horizon.

The state is phasing in new regulations aimed at boosting staff training, providing better oversight of diets and ensuring proper air conditioning and access to emergency power.

"While there are problems, we feel they are being addressed by the new regulations," said Walt Smiley of the Joint Legislative Audit and Review Commission.

However, the regulations come with a price, and homes that serve large numbers of poor people could have problems complying with them, the report says. Low-income people depend on a type of government grant that falls well short of paying the going market rate for assisted living care.

The JLARC report comes three years after a series of stories in the Washington Post documented cases of neglect and violence in assisted living centers that care for the aged and disabled. The stories also questioned the state's oversight role.

In 2005, the General Assembly passed legislation that gave the Department of Social Services new enforcement power and authorized the Department of Health Professions to train staff. The measures were to be phased in over three years.

In the meantime, the number of problem homes appears to have decreased, but the data are not conclusive, the study says.

A 2006 report documented 137 facilities "of concern," while Monday's report flagged 114. However, the law does not define quality of care in so many words, so investigators relied on two indicators: the number of verified complaints and documented problems in complying with state standards.

A home might provide poor care but have few complaints, the report says. Conversely, a home with many complaints could have had a single bad employee who was later fired.

As of February, Virginia had 583 licensed assisted living facilities that could serve nearly 32,000 people. Residents range in age from 18 to more than 100. They typically do not need full-time nursing or medical care, but they cannot live on their own.

They can include the frail elderly and people with mental disabilities, such as Alzheimer's disease. Assisted living centers serve four or more people.

The 114 facilities that investigators flagged had some common characteristics. Larger centers -- those with 20 or more residents -- tended to have more complaints or compliance problems. Also, problem facilities were more common in four regions of the state: western Virginia, Fairfax in Northern Virginia, Verona (south of Harrisonburg) and the Piedmont area of central Virginia.

The Peninsula had one of the lowest concentrations of problems, the report found.

The new regulations, once fully phased in, call for training administrators and aides, allowing a dietitian to review special diets and providing connections for temporary electrical power.

The grant that serves low-income residents, while it has been increased, has not accounted for the cost of the new regulations. *

ONLINE

To read or download the entire report, go to http://jlarc.state.va.us/ Meetings/July07/ALFrpt.pdf